2026 Wellcare Mastery Exam with correct answers 100%

2026 Wellcare Mastery Exam with correct answers 100% The ___ offers detailed information on the member's plan and costs to help the member understand the benefits and rules of their plan. - Correct Answer B. Evidence of Coverage Wellcare's county footprint expanded into ___ states. - Correct Answer D. 8 In 2026, Medicare Advantage Part D (MAPD) plans will adopt one of five distinct formularies, each tailored to specific product types, with each following a standardized five-tier structure. - Correct Answer Following a standardized six-tier structure. Agents may be investigated for non-compliant behavior based on any of the following activities, EXCLUDING: - Correct Answer D. Yelp review Disciplinary actions stemming from the result of a reported allegation are always progressive. - Correct Answer FALSE A reported non-compliant behavior investigation that results in a ____ disposition is one where the investigation produced evidence that the alleged misconduct occurred. - Correct Answer A. Founded The Integrated Care Dual Eligible Special Needs Plan (D-SNP) Special Election Period (SEP) allows beneficiaries to make a one-time per ___ election into a Fully Integrated Dual Eligible (FIDE) SNP, a Highly Integrated Dual Eligible (HIDE) SNP, or an Applicable Integrated Plan (AIP): - Correct Answer B. Month A completed Scope of Appointment (SOA), signed or accepted, is required within 3 days of a sales appointment. - Correct Answer FALSE The Third-Party Marketing Organization (TPMO) disclaimer must be used by any TPMO that sells plans on behalf of more than one Medicare Advantage (MA) plan provider. - Correct Answer TRUE Consent to enroll must be obtained verbally on the recording, or via electronic signature provided by the beneficiary or their legal representative. - Correct Answer TRUE A Late Enrollment Penalty (LEP) is assessed by the Centers for Medicare & Medicaid Services (CMS) when a member goes ____ days or longer without creditable prescription drug coverage after they become Medicare eligible. - Correct Answer B. 63 days Low-Income Subsidy (LIS), which is often referred to as Extra Help, does not apply to Part C but eliminates all Part D plan premiums. - Correct Answer FALSE ___ have the Integrated Care Dual Eligible Special Needs Plan (D-SNP) Special Election Period (SEP) available to them. - Correct Answer A. Full-benefit dual eligible Use of the Pre-Enrollment Checklist (PECL) is a Centers for Medicare & Medicaid Services (CMS) requirement and requires review with beneficiaries prior to the completion of the enrollment for paper and telephonic enrollments. - Correct Answer TRUE A valid exception to the 48-hour rule for Scope of Appointments (SOA) is if a beneficiary initiates an unscheduled in-person meeting or places an inbound call. - Correct Answer TRUE A request to the plan from a member or provider for a formal review of an Action (Denial) or Adverse Plan Determination (Medicare) is ___. - Correct Answer B. An Appeal All Medicare grievances will be resolved within ___ days from the date the plan is made aware of the issue. - Correct Answer A. 30 An oral or written request to the plan, provider, or facility requesting information on benefit changes or preferred drugs is ___. - Correct Answer C. An Inquiry Grievance requests, or any evidence concerning a grievance, must be filed orally or in writing no later than ___ calendar days from the date of the event or the date the member is made aware of the issue. - Correct Answer A. 60 A ___ Special Needs Plan (SNP) is for beneficiaries eligible for both Medicare and Medicaid, are enrolled in Medicare Part A and Part B, and are receiving full Medicaid benefits and/or assistance with Medicare premiums or cost-sharing through one of the Medicare Savings Program (MSP) categories. - Correct Answer B. Dual Eligible For 2026, Wellcare has 41 new plans going to market. - Correct Answer TRUE Wellcare offers products to meet the needs of a variety of beneficiaries. We offer: - Correct Answer D. All of these The Wellcare Spendables® Card provides allowance for specific key benefits, loaded onto a single card to provide members with flexibility to use as best fits their needs. - Correct Answer TRUE Exclusively aligned enrollment occurs when state policy limits enrollment in a D-SNP to only ___ individuals who receive coverage of Medicaid benefits through the D-SNP and a Medicaid managed care plan owned and operated by the same parent company as the D-SNP. - Correct Answer A. Full-Benefit Dually Eligible For 2026, preferred networks include: - Correct Answer D. All of these: Walgreens, CVS, and some grocery chains The Medicare Prescription Payment Plan, while not a cost savings program, is